Postgraduate student, Oral Diagnostic at the Department of Dentistry Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Postgraduate student, Oral Diagnostic at the Department of Dentistry Federal University of Santa Catarina, Florianópolis, SC, Brazil.
J Prosthet Dent. 2018 Mar;119(3):354-362. doi: 10.1016/j.prosdent.2017.07.005. Epub 2017 Sep 28.
Ceramic restorations are popular because of their excellent optical properties. However, failures are still a major concern, and dentists are confronted with the following question: is sleep bruxism (SB) associated with an increased frequency of ceramic restoration failures?
The purpose of this systematic review and meta-analysis was to assess whether the presence of SB is associated with increased ceramic restoration failure.
Observational studies and clinical trials that evaluated the short- and long-term survival rate of ceramic restorations in SB participants were selected. Sleep bruxism diagnostic criteria must have included at least 1 of the following: questionnaire, clinical evaluation, or polysomnography. Seven databases, in addition to 3 nonpeer-reviewed literature databases, were searched. The risk of bias was assessed by using the meta-analysis of statistics assessment and review instrument (MAStARI) checklist.
Eight studies were included for qualitative synthesis, but only 5 for the meta-analysis. Three studies were categorized as moderate risk and 5 as high risk of bias. Clinical and methodological heterogeneity across studies were considered high. Increased hazard ratio (HR=7.74; 95% confidence interval [CI]=2.50 to 23.95) and odds ratio (OR=2.52; 95% CI=1.24 to 5.12) were observed considering only anterior ceramic veneers. Nevertheless, limited data from the meta-analysis and from the restricted number of included studies suggested that differences in the overall odds of failure concerning SB and other types of ceramic restorations did not favor or disfavor any association (OR=1.10; 95% CI=0.43 to 2.8). The overall quality of evidence was considered very low according to the GRADE criteria.
Within the limitations of this systematic review, the overall result from the meta-analysis did not favor any association between SB and increased odds of failure for ceramic restorations.
陶瓷修复体因其出色的光学性能而广受欢迎。然而，失败仍然是一个主要关注点，牙医面临着以下问题：磨牙症（SB）是否与陶瓷修复体失败的频率增加有关？
本系统评价和荟萃分析的目的是评估 SB 是否与陶瓷修复体失败增加有关。
选择了评估 SB 参与者中陶瓷修复体短期和长期存活率的观察性研究和临床试验。睡眠磨牙症的诊断标准必须至少包括以下之一：问卷、临床评估或多导睡眠图。除了 3 个非同行评审文献数据库外，还搜索了 7 个数据库。使用荟萃分析的统计学评估和审查工具 (MAStARI) 检查表评估偏倚风险。
纳入了 8 项研究进行定性综合分析，但只有 5 项研究进行了荟萃分析。有 3 项研究被归类为中度风险，5 项研究为高偏倚风险。研究之间的临床和方法学异质性被认为很高。仅考虑前牙陶瓷贴面时，观察到更高的风险比（HR=7.74；95%置信区间 [CI]=2.50 至 23.95）和优势比（OR=2.52；95% CI=1.24 至 5.12）。然而，荟萃分析和纳入研究数量有限的数据表明，SB 和其他类型陶瓷修复体的总体失败几率差异并不支持或不支持任何关联（OR=1.10；95% CI=0.43 至 2.8）。根据 GRADE 标准，证据的总体质量被认为非常低。
在本系统评价的限制范围内，荟萃分析的总体结果不支持 SB 与陶瓷修复体失败几率增加之间存在任何关联。
